本文選題：青壯年 + 后內(nèi)壁骨缺損��； 參考：《南華大學(xué)》2015年碩士論文

【摘要】：目的:對(duì)青壯年股骨頸骨折伴后內(nèi)壁骨缺損這種特殊類型的骨折行三枚空心螺釘與DHS加防旋螺釘固定的穩(wěn)定性進(jìn)行三維有限元分析并進(jìn)行比較研究,以期為這一特殊類型股骨頸骨折內(nèi)固定方式的臨床應(yīng)用提供理論依據(jù)。方法:選取一名男性健康青壯年中國(guó)公民,44歲,體重75kg,要求雙側(cè)股骨、髖關(guān)節(jié)正常,無外傷史,對(duì)CT影像資料用途知情并同意。予以雙側(cè)股骨全長(zhǎng)正、側(cè)位、骨盆正位透視排除股骨、髖關(guān)節(jié)疾患后,通過雙側(cè)股骨CT薄層掃描獲取相關(guān)數(shù)據(jù),運(yùn)用Geo Magic11.0、Mimics10.0和Ansys14.0等軟件,建立左側(cè)伴后內(nèi)壁骨缺損股骨頸骨折的三維有限元模型。依據(jù)兩種固定系統(tǒng)內(nèi)植物的相關(guān)掃描數(shù)據(jù),建立對(duì)應(yīng)的三維有限元模型,分別將其導(dǎo)入左側(cè)伴后內(nèi)壁骨缺損的股骨頸骨折模型。設(shè)定邊界和載荷條件,通過對(duì)人行走正常步態(tài)三種工況進(jìn)行分析,得到股骨、內(nèi)植物、骨折斷面不同部位的位移值、位移分布和應(yīng)力值、應(yīng)力分布,分析三枚空心螺釘與DHS加防旋螺釘固定的穩(wěn)定性。結(jié)果:建立青壯年伴后內(nèi)壁5mm骨缺損的股骨頸骨折分別行三枚空心螺釘和DHS加防旋螺釘固定的三維有限元模型,模擬人行走正常步態(tài)三種工況下對(duì)股骨近端進(jìn)行加載,DHS組較空心釘組內(nèi)固定傳導(dǎo)更多的應(yīng)力,而DHS組較空心釘組的股骨頸傳導(dǎo)更小的應(yīng)力,DHS組較空心釘組股骨頭的整體位移值減小;DHS組較空心釘組內(nèi)植物的整體位移值減小;DHS組在骨折斷面不同部位裂隙距離位移值較空心釘組減小,DHS組與空心;釘組在骨折斷面不同部位裂隙距離位移值存在顯著性差異,P0.05,具有統(tǒng)計(jì)學(xué)意義。結(jié)論:對(duì)青壯年伴后內(nèi)壁骨缺損經(jīng)頸型股骨頸骨折(PauwelsⅢ型),DHS加防旋螺釘固定的骨折面應(yīng)力與裂隙距離、內(nèi)植物總位移值、股骨整體位移值均小于三枚空心螺釘,具有生物力學(xué)優(yōu)勢(shì)。
[Abstract]:Objective: to analyze and compare the stability of three hollow screws and DHS screw fixation in the fracture of femoral neck with posterior inner wall bone defect in young adults. In order to provide theoretical basis for the clinical application of this special type of femoral neck fracture internal fixation. Methods: a male healthy young Chinese citizen, aged 44 years, weighing 75 kg, required bilateral femur, hip joint normal, no history of trauma, and informed and agreed to the use of CT imaging materials. The total length of femur, lateral position and pelvic position were excluded from femoral and hip joint diseases. The relevant data were obtained by thin slice CT scanning of bilateral femur, and the software of Geo Magic11.0 Mimics10.0 and Ansys14.0 were used. A three-dimensional finite element model of femoral neck fracture with left internal bone defect was established. According to the relative scanning data of the plants in the two fixation systems, the corresponding three-dimensional finite element model was established and introduced into the left femoral neck fracture model with posterior wall bone defect respectively. By setting the boundary and loading conditions, the displacement, displacement distribution, stress distribution and stress distribution of different parts of femur, internal plant and fracture section were obtained by analyzing the normal gait of human walking. The stability of three hollow screws and DHS with anti-screw fixation was analyzed. Results: three dimensional finite element models of femoral neck fracture with posterior wall 5mm bone defect and three hollow screws and DHS screw fixation were established. The loading of proximal femur in DHS group was more stress conduction than that in hollow nail group under three working conditions of simulated human walking normal gait. The stress of femoral neck conduction in DHS group is smaller than that in hollow nail group. The global displacement of femoral head in DHS group is smaller than that in hollow nail group, and the fracture distance in different parts of fracture section in DHS group is smaller than that in hollow nail group. The displacement value was lower in DHS group and hollow group than in hollow nail group. There was significant difference in the displacement of fracture distance between nail group and fracture section (P 0.05). Conclusion: the fracture surface stress and fracture distance, the total displacement of the implants, the total displacement of the femur and the total displacement of the femur were less than three hollow screws in the young adults with posterior internal wall bone defect and Pauwels type 鈪，

本文編號(hào)：1891424